McGrath Orlaith E, Aslam Tariq M
Manchester Royal Eye Hospital, Manchester, UK.
The University of Manchester, Manchester, UK.
Ophthalmol Ther. 2022 Jun;11(3):1017-1030. doi: 10.1007/s40123-022-00509-8. Epub 2022 Apr 29.
To evaluate the effect of COVID-19 on retinal tissues by conducting a systematic review and meta-analysis of the current literature.
The novel coronavirus disease is not yet well understood. The orbit provides a window into the body's microvasculature, and as such, it is a non-invasive opportunity to analyse the systemic circulation in vivo. By analysing the current literature, we test the hypothesis that non-invasive imaging of the retina could provide insight into the effect of COVID-19 on the retinal microvasculature.
For this systematic review and meta-analysis, we screened PubMed databases and LitCOVID19 using the search criteria: (OCTA or Optical Coherence Tomography Angiography) AND (COVID-19 or corona or SARS-CoV-2) AND (retina or fundus). Databases were searched on 11 January 2022. The primary study outcomes were studies that utilised OCTA to analyse the retina; secondary outcomes involved studies that involved other imaging modalities such as OCT, fundus photography, and fundus autofluorescence.
The total number of studies included in this review was 32. Optical coherence tomography angiography scans show reduced central retinal vascular density, a thinner ganglion cell layer, a thicker retinal nerve fibre layer, and an enlarged foveal avascular zone. Optical coherence tomography scans demonstrate a thicker central macular thickness and other changes to the macula, ganglion cell, and inner nuclear layers. Many fundus photographs depicted cotton wool spots, microhaemorrhages, and vascular occlusions. Non-invasive imaging technology has demonstrated that COVID-19 can profoundly affect the retina. Therefore, there is a requirement for long-term follow-up of COVID-19 patients to assess whether the retinal damage caused by COVID-19 is reversible.
通过对当前文献进行系统评价和荟萃分析，评估新型冠状病毒肺炎（COVID-19）对视网膜组织的影响。
新型冠状病毒病尚未被充分了解。眼眶为观察人体微血管系统提供了一个窗口，因此，它是在体内分析全身循环的一个非侵入性机会。通过分析当前文献，我们检验了这样一个假设，即视网膜的非侵入性成像可以深入了解COVID-19对视网膜微血管系统的影响。
对于这项系统评价和荟萃分析，我们使用搜索标准在PubMed数据库和LitCOVID19中进行筛选：（光学相干断层扫描血管造影术或OCTA） AND （新型冠状病毒肺炎或冠状病毒或严重急性呼吸综合征冠状病毒2） AND （视网膜或眼底）。于2022年1月11日检索数据库。主要研究结果是利用光学相干断层扫描血管造影术分析视网膜的研究；次要结果涉及其他成像方式的研究，如光学相干断层扫描（OCT）、眼底摄影和眼底自发荧光。
本评价纳入的研究总数为32项。光学相干断层扫描血管造影术扫描显示视网膜中央血管密度降低、神经节细胞层变薄、视网膜神经纤维层增厚以及黄斑无血管区扩大。光学相干断层扫描显示中央黄斑厚度增加以及黄斑、神经节细胞和内核层的其他变化。许多眼底照片显示有棉絮斑、微出血和血管阻塞。非侵入性成像技术已证明COVID-19可对视网膜产生深远影响。因此，需要对COVID-19患者进行长期随访，以评估COVID-19引起的视网膜损伤是否可逆。
